Comparison of 19G vs 22G Franseen-tip-EUS-FNB device for patient derived organoid (PDO) yield from primary pancreatic cancer: a prospective controlled study

Introduction Patient derived organoids (PDOs) from pancreatic cancer are deemed powerful models of pancreatic cancer. Therefore, they undergo clinical evaluation as tools for personalized treatment. One requirement for the successful conduction of such trials is an optimized protocol for tissue acquisition. EUS-FNB is an emerging technique to acquire high-quality tissue samples for pathological analysis, but the optimal FNB-protocol for organoids is unknown.

Methods This is a single-institution, prospective, controlled study comparing 19G and 22G Franseen-tip-EUS-FNB-device (Boston Scientific Acquire™) for PDO isolation from primary pancreatic cancers. Patients with clinical indication for EUS-FNB and written informed consent were eligible. Patients underwent two needle passes with each FNB-device. One of each sample was sent for pathology analysis; the other was kept for organoid isolation. A PDO cell line was considered established, if organoids remained viable beyond 5th passages and survived one cycle of cryopreservation. The study was approved by local IRB.

Results Between 04/2019 and 10/2020, 25 patients were recruited of which five did not have pancreatic cancer on follow-up. In the remaining 20 patients (9 female, median age 66 [55 to 81 years]), 10 PDOs could be established from samples taken by 19G and 11 from 22G needle (p = .9999; Fisher´s exact test). In eight patients, a PDO was established from both needle sizes, the overall success rate was 65 %.

Conclusion In this prospective, controlled study, a larger EUS-FNB needle did not result in higher PDO-yield from pancreatic tumors. Upcoming trails utilizing PDOs for personalized treatment should therefore not mandate 19G EUS-FNB needles.

Publication History

Article published online:
07 September 2021